24 complex claims specialist jobs found

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early return-to-work efforts with the...

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.   Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.   Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where...

Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.   Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.   Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where...

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early return-to-work efforts with the...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements in compliance with all state regulatory requirements. Property Adjuster Specialist focus on using technology and desk adjusting for a virtual first approach to inspections and claims handling....

Description Are you looking to use your customer service skills in a role where you can see that you are making a difference in people’s lives? Are you looking for a position that allows you to do meaningful and innovative work in a culture of continuous improvement? If so, this opportunity could be for you! Liberty Mutual’s Large Loss Claims Property team has an immediate opening for a Personal Property Claims Specialist. As a Claims Specialist, you will manage, investigate and resolve assigned Property Contents claims under general supervision. Responsibilities include: capturing and creating an inventory of damaged/lost contents while on site, working with various vendors and ensuring that quality customer service is provided via face to face and phone interaction. Manages, investigates and resolves assigned Property Contents claims for more complex claims under limited supervision. Compiles and values inventory of high-end damaged/lost contents associated...

At AIG, we are reimagining the way we help customers to manage risk. Join us as an Underwriting Specialist, Admitted Casualty to play your part in that transformation. It’s an opportunity to grow your skills and experience as a valued member of the team. Make you mark in Underwriting AIG underwriting teams help to find insurance solutions in areas including Financial Lines, Property, Casualty, Specialty Lines, Cyber, Multinational Clients, and High Net Worth individuals. We are reimagining how we help customers to manage risk, transforming our operating model, and reshaping our role responsibilities and career pathways. The goal is to unlock the full potential in each colleague – empowering our people to grow as insurance professionals and add more value to our customers and AIG. How you will create an impact The Underwriting Specialist will be responsible for underwriting the Workers’ Compensation, General Liability and Auto Liability primary Casualty product lines...

The salary range for this job posting is $97,153.00 - $155,445.00 annually + bonus + benefits. Pay Type: Salary The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. Encova Insurance is seeking an experienced General Adjuster to join our high-performing claims team. This is a home-based position with travel required for claims, and while we prefer candidates based in the western Pennsylvania area, we will consider well-qualified individuals residing in Ohio or West Virginia. At Encova, we believe in fostering an environment where each associate is valued and empowered to succeed. Our commitment to professional development, supportive teamwork, and offering exceptional benefits makes us a...

Position Summary The Captive Insurance Accounting and Reporting Analyst is an integral part of the financial team, specializing in the unique accounting and reporting needs of captive insurance entities. This role involves a blend of complex accounting tasks, regulatory compliance, and strategic financial analysis. The specialist ensures the financial integrity of the captive insurance operations, providing valuable insights that drive business decisions. What will your job entail? Job Responsibilities: • Manage the administration of insurance policies, ensuring all policy documents are accurate and up to date. • Oversee the processing of insurance claims, ensuring they are handled efficiently and accurately. • Analyze financial data to identify trends, make forecasts, and provide recommendations for financial planning. • Prepare and file tax returns for the captive insurance entities, ensuring compliance with tax laws and regulations. • Monitor the performance of the...

Company: Guy Carpenter Description: We are seeking a talented individual to join our team at Guy Carpenter. This role will be based in Philadelphia, PA or Norwalk, CT . This is a hybrid role that has a requirement of working at least three days a week in the office. This role is responsible for managing complex portfolios, including processing all technical transactions related to excess loss, pro rata, or facultative reinsurance, such as coverage assessment, premium and loss transactions, and cash disbursements. Additionally, provide guidance and training to less experienced colleagues and perform leadership and business support duties as assigned by the team or department manager. We will count on you to: Manage a complex client portfolio, ensuring accurate processing of premiums, client activity, and timely follow-up, while supporting collection and cash application initiatives. Ensure timely settlement of funds, adhering to all payment warranties and...

Overview Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett’s Berkshire Hathaway group – one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.   Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company’s success is grounded in our core values:  accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path!...

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgement of the claim Determines the validity and compensability of the claim Establishes reserves and authorizes payments within established reserving authority limits Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent customer service skills Excellent written and verbal communication skills Fast learner; develops knowledge and understanding of...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...

The Float Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...

Join us as a Product Development Manager to make more of your specialist expertise and experience. Make your mark in AIG PROGRAMS. PRODUCT DEVELOPMENT MANAGER The Product Development Manager position is responsible for managing the tasks and processes associated with the product development, filing submission/approval and implementation of new or revised products (rates/rules/forms) for use within the Programs Division.  How you will create an impact Maintain product and filings knowledge and ownership of assigned products/programs. Assist Underwriting and Program Development in the analysis, development and documentation of products (rates/rules/forms) with a focused responsibility for rate/rule page manuals development and complex forms drafting. Coordinate product review with various stakeholders (Program Managers, Product Line Officers, Actuarial, Claims, Compliance, Systems, Program Administrator, etc.) and drive to conclusion the Legal review and approval...

About Acrisure Acrisure is a global Fintech leader that combines the best of humans and high tech to offer multiple financial products and services to millions of businesses and individual clients. We connect clients to solutions that help them protect and grow what matters, including Insurance, Reinsurance, Cyber Services, Mortgage Origination and more. Acrisure employs over 19,000 entrepreneurial colleagues in 22 countries and has grown from $38 million to $4.8 billion in revenue in just over ten years. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client centricity and an indomitable will to win. Your Next Chapter:   Do you thrive in an environment where technology, data, and relationships intersect? At Acrisure, we’re redefining what it means to be a sales professional - giving you cutting-edge tools, entrepreneurial freedom, and the backing of a $4.8B global fintech leader. As an Acrisure Business Development...

The salary range for this job posting is $55,132.00 - $110,642.00 annually + bonus + benefits. Pay Type: Salary The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. While we prefer candidates who reside in Pennsylvania, we will consider those who live in any of our listed payroll approved states. We may hire a senior level and the posted salary range is inclusive of both levels. Nurse licensures in multi-states is a plus. The actual salary range for candidates who reside in Pennsylvania is $59,630 to $119,670 annually + bonus + benefits. Pay Type: Salary The position reports to the Director, Workers' Compensation Claims. Are you a Referral? If you know a current Encova...

Is the opportunity to join a culture where “We Do the Right Thing,” and “We Courageously Shape Our Future Together” important to you? If so, Guardian is seeking a talented and motivated individual to join our team as Senior Corporate Security Specialist. In this role, you will be a key contributor to the Global Security Operations Center (GSOC) Team working on potential incidents, such as emergency and/or crisis situations that would threaten the safety or security of Guardian’s people, property, and business operations. This position requires knowledge of security threat environment, critical thought, knowledge, and use of Microsoft Office (Teams, Word, Excel, PowerPoint), knowledge and use of security focused computer applications. Provided you have the required certifications and approvals, you may also act as a first responder for emergencies, evacuations, and active shooter incidents supporting the Guardian home office location in Bethlehem, PA. as an armed, on-site...

The Broker Dealer Operations Specialist plays a central role in delivering world‑class customer and transaction servicing for alternative investment products. The role supports end‑to‑end operations from onboarding through transactions, reconciliation, and servicing requests. You are A consummate professional with excellent verbal and written communication skills Self-motivated and goal-oriented Patient, empathetic, diligent, and able to work independently in a team environment You will Serve as the SME and primary contact for Alternative Investments operational inquiries and daily processing. Develop an in‑depth understanding of iCapital platform interfaces and order entry within NetX360 to enable seamless fund launches, recurring client activities, and overall book health. Execute operations deliverables on recurring platforms; manage daily workflows and queues to meet service levels with a client‑first approach. Assist in systems testing and...

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Risk Control Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program,...